Provider Demographics
NPI:1033508403
Name:MARK PINSKER ED D LLC
Entity Type:Organization
Organization Name:MARK PINSKER ED D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:PINSKER
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:804-380-9488
Mailing Address - Street 1:1241 MALL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4879
Mailing Address - Country:US
Mailing Address - Phone:804-380-9488
Mailing Address - Fax:
Practice Address - Street 1:1241 MALL DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4879
Practice Address - Country:US
Practice Address - Phone:804-380-9488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1720103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty